Lack of Durability of Surgical Arterialization of Coronary Veins for the Treatment of Ischemic Heart Disease

Chowdhry, Mohammed Fiyaz; Davies, Joan; McCance, A J; Galiñanes, Manuel

doi:10.1111/j.1540-8191.2005.200489.x

Cited by 9 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The procedure allows performance of sequential bilateral mammary artery grafting combined with selective arterialization of the coronary venous system; ischemia was reduced in all patients and substantial improvement was seen in cardiac function and quality of life, suggesting a better long-term prognosis and the likelihood of extensive application of the technique [24] . In contrast, earlier human studies suggested a lack of durability of arterialization of coronary vein and expressed doubts that the technique was useful for revascularization of the ischemic myocardium [25] .…”

Section: Discussionmentioning

confidence: 94%

Outcomes of Middle Cardiac Vein Arterialization via Internal Mammary/Thoracic Artery Anastomosis

Gao

et al. 2013

PLoS ONE

View full text Add to dashboard Cite

ObjectiveCardiac vein arterialization is seldom applied for treating right coronary artery disease. This study aimed to improve outcomes of cardiac vein arterialization in a porcine model using intramammary artery anastomosis.MethodsA chronic, stenotic coronary artery model was established in 12 of 14 Chinese experimental miniature pigs of either sex, which were randomly divided into equal control (n = 6) and experimental (n = 6) groups. In experimental animals, blood flow was reconstructed in the right coronary artery using intramammary artery. Arterialization involved dissection of right internal mammary artery from bifurcation to apex of thorax followed by end-to-side anastomosis of internal mammary artery and middle cardiac vein plus posterior descending branch of right coronary artery. Intraoperative heart rate was maintained at 110 beats/min. Graft flow assessment and echocardiography were performed when blood pressure and heart rate normalized.ResultsThe experimental group had significantly higher mean endocardial and epicardial blood flow postoperatively than control group (mean endocardial blood flow: 0.37 vs. 0.14 ml/(g*min), p<0.001; mean epicardial blood flow: 0.29 vs. 0.22, p = 0.014). Transmural blood flow was also higher in experimental group than in control group (0.33 vs. 0.19, p<0.001); ejection fraction increased from 0.46% at baseline to 0.51% (p = 0.0038) at 6 hours postoperatively, and mean blood flow of internal mammary artery was 44.50, perfusion index 0.73 at postoperative 6 months, 43.33 and 0.80 at 3 months.ConclusionSuccessful cardiac vein arterialization via intramammary artery in a porcine model suggests that this may be a viable method for reconstructing blood flow in chronic, severe coronary artery disease.

show abstract

Section: Discussionmentioning

confidence: 94%

Outcomes of Middle Cardiac Vein Arterialization via Internal Mammary/Thoracic Artery Anastomosis

Gao

et al. 2013

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…For severe cases of diffuse RCA lesions, CE often fails to create a suitable anastomosis target for subsequent RCA revascularization ( 8 ). Selective coronary vein bypass grafting (SCVBG) can provide retrograde perfusion of the myocardium from the middle cardiac vein (MCV), effectively improving myocardial perfusion of the ischemic area of the RCA ( 9 , 10 ). However, there are few reports on the clinical efficacy of SCVBG.…”

Section: Introductionmentioning

confidence: 99%

Selective coronary vein bypass graft improves outcomes of patients with right coronary artery lesion

Dai,

Yu,

Gao

et al. 2023

J Thorac Dis

View full text Add to dashboard Cite

Background The benefits of selective coronary vein bypass grafting (SCVBG) for patients with severe diffuse lesions of the right coronary artery (RCA) who are unsuitable for coronary endarterectomy (CE) are unclear. Methods We recruited patients with diffuse lesions of the RCA undergoing coronary artery bypass surgery between January 2015 and December 2018 and matched SCVBG and CE patients on propensity score (PS). We evaluated the degree of single-stenosis in the RCA, incidence of perioperative myocardial infarction (MI) and major adverse cardiovascular and cerebrovascular events (MACCE), influencing factors of perioperative MACCE, long-term survival rate, and long-term MACCE incidence. Results Overall, 430 patients were enrolled: 344 (80%) underwent CE and 86 (20%) underwent SCVBG (n=78 and n=64, respectively, after PS matching). The incidence of perioperative MI and MACCE were significantly lower in the SCVBG group (5.1% vs. 1.5%, P<0.05; and 10.2% vs. 4.7%, P<0.05). When the vascular flow rate of the graft anastomosed to RCA in the SCVBG group was above 100 mL/min, the incidence of perioperative MACCE significantly increased [odds ratio (OR): 1.94, 95% confidence interval (CI): 1.42–2.03]. Choosing the bilateral internal mammary artery for SCVBG reduced the incidence of perioperative MACCE (OR: 0.82, 95% CI: 0.68–0.92). There was no significant difference in the rates of long-term survival or MACCE between the two groups before or after PS matching (P>0.05). Conclusions SCVBG is an acceptable surgical intervention for patients with severe diffuse RCA lesions.

show abstract

Blood Flow Changes in Normal and Ischemic Myocardium During Topically Applied Negative Pressure

Lindstedt¹,

Malmsjö²,

Ingemansson³

2007

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Lack of Durability of Surgical Arterialization of Coronary Veins for the Treatment of Ischemic Heart Disease

Abstract: In conclusion, these results indicate that arterialization of the coronary veins is not durable and that it is unlikely that this strategy is a useful technique for the revascularization of the ischemic myocardium.

Cited by 9 publications

References 11 publications

Outcomes of Middle Cardiac Vein Arterialization via Internal Mammary/Thoracic Artery Anastomosis

Outcomes of Middle Cardiac Vein Arterialization via Internal Mammary/Thoracic Artery Anastomosis

Selective coronary vein bypass graft improves outcomes of patients with right coronary artery lesion

Blood Flow Changes in Normal and Ischemic Myocardium During Topically Applied Negative Pressure

Contact Info

Product

Resources

About